The Nutrition Corner

The GI Associates' have a commitment to help you feel better and stay that way. And we understand that long-term health depends on sound nutrition. There are always times when medicines are not just necessary but are the best choice for your health; but nutrition can also help your medicines work at their best. That's why we have a staff Registered Dietician - meet Sandy Davis, MS, RD, LD.

Sandy has 25+ years of professional experience as a Registered Dietitian counseling individuals of all age groups with GI disease (including celiac disease/gluten sensitivity), diabetes, weight management and cardiovascular disease. She has also taught nutrition at community colleges in both Mississippi and south Florida. She earned both her Bachelors and Master’s of Science in Nutrition at Indiana State University. She is a member of the American Dietetic Association, Mississippi Dietetic Association and dietetic practice groups which specialize in weight management, medical nutrition therapy and celiac disease.

Below are a sampling of blog posts written by Sandy giving advice on how nutrition plays a part in the treatment of many GI conditions. A new post will be added monthly.  Like us on Facebook and you will be informed of new blog entries as they happen. If you want to see the rest of the collection please see our blog archive in the Explore section to your right.

What Ails You?

Elimination or exclusion-type diets are becoming a big part of my world working as a Registered Dietitian (R.D.) in a busy GI clinic. They can be thought of as “steer clear of” type diets for food allergies or intolerances. The gluten-free diet is an example of an exclusion diet. It is the diet used for individuals with celiac disease or suspected gluten sensitivity. I have written a number of blogs about the challenges faced on a gluten free diet (See Blog archive).

Recently, elimination diets have found their place with the treatment of eosinophilic esophagitis (EE) for both adults and children. Eosinophils are a type of white blood cell (fighter cell) normally found in the intestine, but not in the esophagus (wind pipe). Think of eosinophils as a bull in a china shop. A bull in a china shop is a disaster waiting to happen just as finding eosinophils in one’s esophagus. Both are where they don’t belong and can wreak havoc. If left untreated, it can cause thickening and narrowing of the esophagus.

What causes esosinophils to find their way into one’s esophagus? The answer is plain and simple à food allergies. Those suffering from EE have a variety of woes which sends them to a GI doc - reflux which doesn’t get better on acid-blocking meds, difficulty swallowing and/or food gets easily stuck in the throat. Children have a history of reflux, vomiting, food refusal, poor appetite, weight loss and not growing as they should. EE is diagnosed by your GI doc through tissue samples taken during a procedure called an EGD. EE can be controlled with diet alone with some individuals.

Elimination diets may also help certain individuals suffering with IBS. Typically a high fiber diet is used. Some find the high-fiber diet makes them feel worse instead of better. Their woes may be caused by certain carbohydrates they are eating. The diet used is called a FODMAPS Elimination diet. One of our patients had diarrhea-type IBS for over 20 years (can you imagine suffering from diarrhea for 20 + years?!) Drug store and prescription medicines didn’t cure it. He can tell you where every bathroom is located in the Jackson area eating out. He started feeling better during the first few days on the diet. By the end of the week, diarrhea had stopped. As you can well imagine, he was ecstatic. In fact, he almost ended up making a trip to the emergency room from doing a jig in the bathroom. We are now in the process of adding foods back to find out what was causing the diarrhea.

Making an appointment with a dietitian who specializes with GI disorders and the diets used in the treatment of celiac disease or gluten sensitivity, eosinophilic esophagitis (EE) and IBS may make life much easier. Not all dietitians see individuals with GI diseases on a routine basis. Therefore, they may not be well versed with both the nuances of the diets used for treatment, nutritional needs and menu planning.

Thank goodness the food guide pyramid is history! It has been around for more years than I care to remember. Who stacks up food choices inside a psychedelic colored pyramid when trying to figure out what to eat for good health? Not me. Using a plate to convey what makes up a healthy diet makes sense. The U. S. Department of Agriculture finally got it right with the new food guidance icon – ChooseMyPlate.

You may be asking why the big change? The food guide pyramid has been around for almost twenty years, so why the big change now? The change coincides with the new 2010 Dietary Guidelines for Americans released this past January. The guidelines are revised every five years. Usually the revisions are simple ones. The guidelines are used to direct federal government’s nutrition education programs, federal assistance nutrition assistance programs and dietary advice provided by health and nutrition professionals. The new guidelines focus on empowering folks to make healthier food choices and slim down in the process.

In the past, the food guide pyramid was used to help visualize the underlying Dietary Guidelines. A new simple visual icon was needed to convey the underlying messages from the revised guidelines. The key word is “simple”. The current food guide pyramid didn’t cut it. Thus the new plate icon was developed to go along with the newly released 2010 Dietary Guidelines. Lots of new interactive tools are also in the works to be rolled out later in the year. Please feel free to check out www.ChooseMyPlate.gov

Along with the new visual plate, simple how-to messages to help us make healthier choices will be rolled out throughout the year. Stay tuned…in good health!

Baby Carrots - the next junk food?

Watch out Cheetos – you may have some competition in the near future! Yep, that’s right (or I hope so anyway). Trying to get our kids (or ourselves for that matter) to make the switch from snacking on typical junk food (such as chips or cookies) to something healthy (like fruits and vegetables) is a daunting challenge. I think when we attach the “healthy” label to any food or beverage is where we may go wrong. Children typically rebel when we attach the word “healthy” to any food we are trying to finagle them to eat. Somehow the “healthy” just doesn’t taste as good as something labeled “junk food”.

Along the same lines, I recently read a fascinating article about one of the powerhouses in the multimillion dollar baby carrot industry investing in a baby carrot marketing campaign. Apparently baby carrot sales are also suffering as a result of economy woes. Folks are buying regular carrots instead of baby ones to save money. The baby carrot industry took note and hired a marketing firm.

Much work went into studying suburban moms and kids shopping and snacking habits. They found (as we all know), no one ever looks in the refrigerator vegetable or fruit drawer for a snack. Things which are “healthy” lives there! One of the kids studied, called it “the drawer of death.” As a result of much research, the head carrot (person in charge of marketing) decided to market baby carrots as a junk food. If you think about it, they do have some similarities to one of kid’s favorite junk foods - neon orange, crunchy, dippable and somewhat addictive (who eats only one baby carrot?).

In the near future, baby carrots may be displayed and sold in very different manners than we are used to seeing them. In fact, they are being marketed as “Let ‘Em Like Junk Food” in some parts of the country as a test. They are selling baby carrots in high school vending machines in those crinkly sounding and colorful chip type bags.

Cheetos better watch its back….baby carrots are on the way! Happy munching!

F is for Fat

Last year the F as in Fat 2010 Mississippi Press Release (yes there is such a report!) gave Mississippi the dubious number one ranking as being the fattest state in the nation. Not only does the title hold true for adults, but also for the children. One out of every three children or teens is overweight or obese in Mississippi. Sadly, most parents (84% in fact) think their children are at a healthy weight. Unhealthy weights, even in children, may translate into increased risk for chronic disease. I have seen young, school age children in our clinic with Type 2 diabetes mellitus (used to be called adult-onset diabetes – no more!), hypertension and fatty liver.

Children, like adults in Mississippi, aren’t active enough and don’t eat the right types of foods. The newly released Dietary Guidelines for Americans 2010 gives a shocking snapshot of what our kids are eating. The top 25 sources of calories in our kids diets are (in order) sugary refined white flour desserts (think of all those cookies, brownies and little packaged cakes), pizza and sodas. Where are the fruits and veggies? Unfortunately, fruit and veggies are much further down on the list and not the best of choices either. French fries and potato chips round out what kids are eating for their top vegetable choices. Fruit juices, not fruits are the “fruits” of choice. Where’s the green stuff and fresh fruit?

Good eating habits must start at a very early age to prevent children from traveling down the same fat path most adults are struggling to get off. Good eating habits must start well before children reach the age of two. Why is that? Individual taste preferences start forming at a very early age - before the age of two. After the age of two, children develop neophobia (the fear of new things). Dinner time may turn into a battleground if you wait too late to introduce the green stuff. Most parents can relate to “I don’t like that!” in their quest to introduce a new veggie at the dinner table.

Introduce colorful veggies such as cooked broccoli, carrots or green beans with your one year old. Chunk the sugary white flour refined stuff and offer sliced up fruit for dessert. Healthy munching